Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas.
Department of Radiology, University of Chicago, Chicago, Illinois.
Magn Reson Med. 2019 Mar;81(3):2147-2160. doi: 10.1002/mrm.27529. Epub 2018 Oct 28.
We propose a novel methodology to integrate morphological and functional information of tumor-associated vessels to assist in the diagnosis of suspicious breast lesions.
Ultrafast, fast, and high spatial resolution DCE-MRI data were acquired on 15 patients with suspicious breast lesions. Segmentation of the vasculature from the surrounding tissue was performed by applying a Hessian filter to the enhanced image to generate a map of the probability for each voxel to belong to a vessel. Summary measures were generated for vascular morphology, as well as the inputs and outputs of vessels physically connected to the tumor. The ultrafast DCE-MRI data was analyzed by a modified Tofts model to estimate the bolus arrival time, K (volume transfer coefficient), and v (plasma volume fraction). The measures were compared between malignant and benign lesions via the Wilcoxon test, and then incorporated into a logistic ridge regression model to assess their combined diagnostic ability.
A total of 24 lesions were included in the study (13 malignant and 11 benign). The vessel count, K , and v showed significant difference between malignant and benign lesions (P = 0.009, 0.034, and 0.010, area under curve [AUC] = 0.76, 0.63, and 0.70, respectively). The best multivariate logistic regression model for differentiation included the vessel count and bolus arrival time (AUC = 0.91).
This study provides preliminary evidence that combining quantitative characterization of morphological and functional features of breast vasculature may provide an accurate means to diagnose breast cancer.
我们提出了一种新的方法,将肿瘤相关血管的形态学和功能信息进行整合,以辅助诊断可疑的乳腺病变。
对 15 例可疑乳腺病变患者进行了超快速、快速和高空间分辨率的 DCE-MRI 数据采集。通过对增强图像应用 Hessian 滤波器,将血管从周围组织中分割出来,生成每个体素属于血管的概率图。对血管形态以及与肿瘤物理连通的血管的输入和输出进行了总结性测量。对超快速 DCE-MRI 数据进行了改进的 Tofts 模型分析,以估计 bolus 到达时间(K)、体积转移系数(K)和血浆体积分数(v)。通过 Wilcoxon 检验比较良恶性病变之间的各项测量值,然后将其纳入逻辑岭回归模型,以评估它们的联合诊断能力。
共有 24 个病灶纳入研究(13 个恶性,11 个良性)。血管计数、K 和 v 在良恶性病变之间存在显著差异(P = 0.009、0.034 和 0.010,AUC 分别为 0.76、0.63 和 0.70)。用于区分的最佳多元逻辑回归模型包括血管计数和 bolus 到达时间(AUC = 0.91)。
本研究初步表明,结合乳腺血管形态学和功能特征的定量描述,可能为诊断乳腺癌提供一种准确的方法。